312 THYROID GLAND IN CARBOHYDRATE METABOLISM 



coincidently an increase in the D/N quotient to as much as 

 3.5 (as seen in the height of phloridzin diabetes). 40 Possibly 

 with these facts in view we may assume that we are justified 

 in looking upon the thyroid and parathyroids as antagonistic 

 in their relations to carbohydrate metabolism. However, 

 the whole matter seems by no means thoroughly established. 



Hyperthyroidism. Hyperthyroidism lowers the assimi- 

 lation limit for sugar. Transitory glycosurias have been met 

 time after time after feeding thyroid tissue (cf. Vol. I of 

 this series, p. 448, Chemistry of the Tissues). In special 

 cases the occurrence of true diabetes has been noted, which 

 may, however, be nothing more than the manifestation of a 

 previously existing disposition toward the affection (as 

 C. v. Noorden believes). In Basedow's disease, too, which 

 we are for the present justified in regarding as a form of 

 hyperthyroidism (cf. Vol. I of this series, p. 456, Chemistry 

 of the Tissues), there may be frequently seen instances of 

 alimentary glycosuria (first discovered by Ludwig and 

 Kraus, and by Chvostek and confirmed by many later ob- 

 servers). This is to be expected, according to the observa- 

 tions of Eppinger in C. v. Noorden's Clinic, in those cases of 

 Basedow's disease which show symptoms of sympathetic 

 irritation, and is usually absent from those cases in which 

 symptoms of vagotonia are prominent. 41 



Interaction of the Internal Secretory Glands. Eppin- 

 ger, Falta and Eudinger have come to very definite ideas as 

 to the interaction of the internal secretory glands, to which 

 they ascribe a regulative influence over normal carbohy- 

 drate metabolism. They assume that exclusion of a " blood 

 gland ' ' will give rise to two distinct effects, primarily direct 

 influences from the loss of the specific secretion and sec- 

 ondarily indirect influences through disturbance of its inter- 

 relation with other glands. 



40 Eppinger, Falta and Rudinger, 1. c.; also R. Hirsch (F. Kraus's Clinic, 

 Berlin), Zeitschr. f. exper. Pathol., 3, 393, 1906; 5, 233, 1908; Handb. d. 

 Biochem., 3', 295, 329, 1910. 



41 C. v. Noorden's Die Zuckerkrankheit, 5th ed., p. 46, 1910. 



